nbme fom 1 - rocks

[ArchivalUser]

Five weeks after vaginal delivery of a healthy full-term newborn, a 22 yeas woman, G 1, P 1, is brought to the physician by her mother because of depressed mood for 2 weeks. Her mother is concerned that her daughter is not able to take care of her infant. Physical examination shows no abnormalities. She is quiet and tearful and does not engage in conversation easily. She states that she lives alone with her infant and has had thoughts of suicide and infanticide. Which of the following is the most appropriate next step in management?
A) Reassurance
B) Long-term outpatient counseling
C) Antipsychotic therapy
D) Selective serotonin reuptake inhibitor therapy
E) Admission to the hospital for treatment

[ArchivalUser]

E - she is a danger to her and her child

[ArchivalUser]

This is post partum depression. i think give her SSRI 's enough. D

[ArchivalUser]

April but she want to kill herself or her baby ..then she is a danger source .. I think we shoud detain her so I go with E

[ArchivalUser]

E. Why do we ask depressive Patients about suicide ideation? We are looking for an excuse to admit them. The patient has admitted such ideation. SSRI could be given to her, but in the hospital. Emergent hospitalisation is the best choice. Alibism

[ArchivalUser]

Thanks u guys for the correction. i was distracted by differentiating bw postpartum depression & pp psychosis & respective pharmacotherapy. E the better choice.

[ArchivalUser]

Postpartum psychosis needs a psychiatric consultation and hospitalisation. Postpartum depression does not necessarily need hospitalization. The patient in Q has to be hospitalized because of her admittance of suicide ideation. Otherwise, anti depressant could be administered to her outpatiently.